A Patient’s Guide to Endometrial Biopsy

Why do I need an endometrial biopsy? What should I expect?
Answers to common questions.

There are several reasons why your gynecologist may wish to perform an endometrial biopsy. We understand that new procedures may cause you concern, so this article explains everything you need to know before it takes place.

Here at All About Women, our compassionate North Florida OB/GYNs will walk you through each step of the process and make sure you’re completely comfortable.

What is an endometrial biopsy?

An endometrial biopsy is the collection of a small sample of cell tissues from your endometrium, which is the lining of your uterus. A laboratory will examine the sample to learn if there are any abnormalities or hormonal changes in the tissue cells. Most gynecologists can perform the endometrial biopsy in the office or in an out-patient clinic. The procedure typically takes 10-15 minutes to complete.

Why is an endometrial biopsy done?

An endometrial biopsy is a medical procedure that enables your gynecologist to confirm or eliminate abnormalities of your uterus and other gynecological diseases. Medical conditions that an endometrial biopsy helps to identify and treat are:

  • Postmenopausal bleeding
  • Abnormal uterine bleeding
  • Endometrial cancer
  • Changes in hormonal levels
  • Absence of uterine bleeding
  • Abnormal fibroids or polyps
  • Uterine infections
  • Abnormal cell tissue or cancer
  • Thickened uterine lining

As beneficial as an endometrial biopsy is, your gynecologist may NOT perform the biopsy if you’re pregnant or your medical records show that you have one or more of the following medical conditions:

  • Acute pelvic inflammatory disease
  • Cervical cancer
  • Severe cervix narrowing
  • Blood clotting disorder

Endometrial biopsy procedure steps

Your gynecologist should explain exactly what will happen during the procedure before you have the biopsy. However, here’s a general overview of how most endometrial biopsy procedures are done.

  • 1. Since the procedure does not require the use of anesthesia, your doctor may give you a sedative 30 minutes before the procedure to lessen any pain, pressure or cramping.

  • 2. You need to empty your bladder just before the biopsy.

  • 3. You will wear a hospital gown and lay on an examination table with your feet placed in stirrups.

  • 4. Your doctor will place a medical device (called a “speculum”) into your vagina to open the area wide enough to see your cervix.

  • 5. An antiseptic solution will be used to clean the cervix and then a medical spray or injection will numb the area.

  • 6. To keep the cervix steady during the biopsy, your doctor will use a forceps (called a “tenaculum”). It is normal to feel some cramping during the attachment of the forceps.

  • 7. Your doctor will insert a thin medical instrument (called a “uterine sound”) through your cervical opening to isolate the location in your uterus for the biopsy. Once the biopsy location is identified, your doctor will remove the uterine sound. You may feel some cramping during this step of the procedure.

  • 8. Your doctor will insert a thin catheter tube into your uterus. There is a smaller tube inside the catheter that your doctor will withdraw. This action causes a suction reaction within the catheter.

  • 9. Your doctor will rotate the end of the catheter while moving it in and out to collect a small sample of endometrial cell tissues. You may experience some cramping during this step of the procedure.
  • 10. Your doctor will remove the catheter and preserve the tissue sample by putting it in fluid before sealing it and sending it to a laboratory for analysis.

  • 11. Your doctor will remove the tenaculum and speculum to end the biopsy procedure.

  • 12. Since it is normal to experience light bleeding after an endometrial biopsy, a nurse will give you a sanitary pad to wear.

Possible side effects from an endometrial biopsy

After the procedure, it is normal to have light blood spotting or vaginal bleeding for 1-2 days. It is also normal to experience mild cramping for a day or so. Because some over-the-counter pain relievers may increase bleeding, ask your gynecologist which medication to take for pain relief.

Call your doctor if you experience any of the following potential side effects after the procedure:

  • Heavy bleeding
  • Bleeding that lasts longer than 2 days
  • Severe pain in your lower abdomen
  • Abnormal vaginal drainage
  • Foul-smelling vaginal discharge
  • Development of a fever or chills caused by an infection

Why see an OB/GYN specialist?

If you are experiencing any of the endometrium symptoms described above, make an appointment with your gynecologist as soon as possible. For the health of your body, seeking the advice and treatment of an OB/GYN specialist means having the best medical attention available.

The compassionate gynecologists at All About Women Obstetrics and Gynecology have extensive experience, knowledge and skill in treating any gynecological condition discovered during the biopsy. If the endometrial biopsy results indicate that follow-up care is required, we’ll work together with you to plan a treatment program tailored to your personal circumstances. Contact us today to schedule an appointment.